title: Quality of life and somatic symptoms in children with constipation: a school-based study.
abstract: OBJECTIVE
  To assess the health related quality of life (HRQoL) and somatization in school children with constipation.
  
  
  METHODS
  This cross-sectional survey was conducted in children aged 13-18 years, in 4 schools in Gampaha district of Sri Lanka. Data were collected using a pretested, self-administered questionnaire with questions on bowel habits, somatization, and HRQoL. Constipation was diagnosed using Rome III criteria.
  
  
  RESULTS
  A total of 1792 children were included in the analysis (males 975 [54.4%], mean age 14.4 and SD 1.3 years). One hundred thirty-eight (7.7%) fulfilled Rome criteria for constipation. Children with constipation had lower HRQoL scores for physical (83.6 vs 91.4 in controls, P < .0001), social (85.0 vs 92.7, P = .0001), emotional (73.6 vs 82.7, P =.0001), school functioning (75.0 vs 82.5, P < .0001), and lower overall scores (79.6 vs 88.0, P = .0001). HRQoL scores were lower in those with fecal incontinence and constipation compared with constipation alone (70.0 vs 81.1, P = .004). Patient perceived severity of abdominal pain (r = -0.22, P = .01) and severity of bowel symptoms (r = -0.22, P = .01) showed significant negative correlation with total HRQoL scores. Total somatization score also found to be negatively correlated (r = -0.47, P < .0001) with HRQoL.
  
  
  CONCLUSIONS
  Children with constipation have lower HRQoL scores than controls in physical, social, emotional, and school functioning. They also have a wide range of somatic symptoms. These issues need to be addressed during clinical evaluation of children with constipation to understand the impact of the disease on the life of affected children and to provide optimal care.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. Electronic address: shamanr0@lycos.com.
authors.forename: Shaman
authors.initials: S
authors.lastname: Rajindrajith
authors.forename: Niranga Manjuri
authors.initials: NM
authors.lastname: Devanarayana
authors.forename: Lasanthi
authors.initials: L
authors.lastname: Weerasooriya
authors.forename: Wathsala
authors.initials: W
authors.lastname: Hathagoda
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
mesh_terms: D015746:Abdominal Pain; D000293:Adolescent; D003248:Constipation / Q000175:diagnosis* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life; D012574:Schools; D013001:Somatoform Disorders / Q000150:complications*; D013188:Sri Lanka; D011795:Surveys and Questionnaires
keywords: FI; Fecal incontinence; HRQoL; Health related quality of life